Pennsaid (Diclofenac sodium)

Do’s

• Apply Pennsaid to clean, dry skin only, as directed by your healthcare provider (usually 2-4 times daily).
• Follow the instructions for priming the pump if using that application method.
• Apply directly to the affected area (usually the knee) and spread evenly over the front, back, and sides.
• Wash hands thoroughly before and after application.
• Let the medication dry completely before touching the treated area, allowing others to touch it, or covering with clothing.
• Use the medication regularly at prescribed intervals and for the prescribed duration (usually no more than 3 months).
• Talk to your healthcare provider if you experience pain and are using Pennsaid "as needed." Applying it at the first signs of pain is most effective.

Don'ts

• Don't apply Pennsaid to eyes, nose, or mouth.
• Don't use it on broken skin, infected areas, or rashes.
• Don't bandage or tightly cover the treated area unless instructed by your healthcare provider.
• Don't shower for at least 30 minutes after application.
• Don't use more than the prescribed dose or for longer than recommended.
• Don't discontinue use without consulting your healthcare provider, especially for chronic conditions like arthritis (full benefit may take up to 2 weeks).

Common side effects:

• Indigestion
• Gas
• Stomach pain
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Headache
• Dizziness
• Drowsiness
• Stuffy nose
• Itching
• Increased sweating
• Increased blood pressure
• Swelling or pain in your arms or legs
• Application site reactions, such as dryness, peeling, redness, itching, pain, skin hardening, rash, blisters, and scabbing

Serious side effects that may require immediate medical attention include:

• Pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating
• Fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling
• Signs of kidney problems, such as change in the amount of urine
• Symptoms of heart failure, such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain
• Serious skin adverse reactions such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal
• Drug Reaction With Eosinophilia And Systemic Symptoms (DRESS)
• Serious cardiovascular events including myocardial infarction and stroke
• Gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal

This is not an exhaustive list, and other side effects may occur. If you experience any unusual or severe side effects while taking Pennsaid,  contact your healthcare provider for medical advice.

Let your healthcare provider know if you have allergies to Pennsaid, aspirin, other NSAIDs (like ibuprofen), or any other medications, including inactive ingredients like dimethyl sulfoxide or propylene glycol.

Inform your healthcare provider about any pre-existing health conditions, especially asthma, aspirin sensitivity, liver disease, stomach/intestinal issues, heart disease, high blood pressure, stroke, swelling, blood problems, or growths in your nose.

NSAIDs like Pennsaid can cause kidney problems, especially for those dehydrated, with heart failure/kidney disease, older adults, or taking certain medications (see Drug Interactions). Drink plenty of fluids and report changes in urine output to your healthcare provider.

Pennsaid may cause dizziness or drowsiness. Avoid driving, operating machinery, or activities requiring alertness until it's safe. Tell your healthcare provider if you use marijuana, which can worsen these effects.

Pennsaid may increase your risk for stomach bleeding. Limit alcohol and quit smoking to reduce this risk. Ask your healthcare provider about safe alcohol consumption.

Pennsaid can make the treated area more sensitive to the sun. Limit sun exposure, avoid tanning beds/lamps, wear protective clothing, and consult your healthcare provider about using sunscreen. Report any sunburn or skin irritation.

Inform your healthcare provider about all medications you take (including Pennsaid) before any surgery.

Older adults are at higher risk for stomach bleeding, kidney problems, heart attack, and stroke while using Pennsaid.

Discuss risks and benefits of Pennsaid with your healthcare provider if you're pregnant or plan to become pregnant. It may harm your unborn baby and is not recommended after 20 weeks. If used between 20-30 weeks, the lowest effective dose for the shortest time is recommended. Do not use it after 30 weeks.

Consult your healthcare provider before breastfeeding as it's unknown if Pennsaid passes into breast milk.